Common use of OTHER CATEGORIES Clause in Contracts

OTHER CATEGORIES. DISABLED INDIVIDUAL any person who: - has a physical or mental impairment that substantially limits one or more major life activity(ies) - has a record of such an impairment; or - is regarded as having such an impairment. • VIETNAM ERA VETERAN a veteran who served at any time between and including January 1, 1963 and May 7, 1975. • GENDER Male (M) or Female (F) PROC-1 (revised 2/2012) REQUEST FOR WAIVER FORM INSTRUCTIONS: SEE PAGE 2 OF THIS ATTACHMENT FOR REQUIREMENTS AND DOCUMENT SUBMISSION INSTRUCTIONS. Offeror/Contractor Name: Federal Identification No.: Address: Solicitation/Contract No.: City, State, Zip Code: M/WBE Goals: MBE % WBE % By submitting this form and the required information, the offeror/contractor certifies that every Good Faith Effort has been taken to promote M/WBE participation pursuant to the M/WBE requirements set forth under the contract.

OTHER CATEGORIES.  DISABLED INDIVIDUAL any person who: - has a physical or mental impairment that substantially limits one or more major life activity(ies) - has a record of such an impairment; or - is regarded as having such an impairment. •  VIETNAM ERA VETERAN a veteran who served at any time between and including January 1, 1963 and May 7, 1975. •  GENDER Male (M) or Female (F) PROC-1 (revised 2/2012) REQUEST FOR WAIVER FORM INSTRUCTIONS: SEE PAGE 2 OF THIS ATTACHMENT FOR REQUIREMENTS AND DOCUMENT SUBMISSION INSTRUCTIONS. Offeror/Contractor Name: Federal Identification No.: Address: Solicitation/Contract NoContractNo.: City, State, Zip Code: M/WBE Goals: MBE % WBE % By submitting this form and the required information, the offeror/contractor certifies that every Good Faith Effort has been taken to promote M/WBE participation pursuant to the M/WBE requirements set forth under the contract.

OTHER CATEGORIES. DISABLED INDIVIDUAL  DISABLEDINDIVIDUAL any person who: - has a physical or mental impairment that substantially limits one or more major life activity(ies) - has a record of such an impairment; or - is regarded as having such an impairment. •  VIETNAM ERA VETERAN a veteran who served at any time between and including January 1, 1963 and May 7, 1975. •  GENDER Male (M) or Female (F) PROC-1 (revised 2/2012) REQUEST FOR WAIVER FORM INSTRUCTIONS: SEE PAGE 2 OF THIS ATTACHMENT FOR REQUIREMENTS AND DOCUMENT SUBMISSION INSTRUCTIONS. Offeror/Contractor NameContractorName: Federal Identification No.: Address: Solicitation/Contract NoContractNo.: City, State, Zip Code: M/WBE Goals: MBE % WBE % By submitting this form and the required information, the offeror/contractor certifies that every Good Faith Effort has been taken to promote M/WBE participation pursuant to the M/WBE requirements set forth under the contract.

OTHER CATEGORIES. DISABLED INDIVIDUAL any person who: - has a physical or mental impairment that substantially limits one or more major life activity(ies) - has a record of such an impairment; or - is regarded as having such an impairment. • VIETNAM ERA VETERAN a veteran who served at any time between and including January 1, 1963 and May 7, 1975. • GENDER Male (M) or Female (F) PROC-1 (revised 2/2012) REQUEST FOR WAIVER FORM INSTRUCTIONS: SEE PAGE 2 OF THIS ATTACHMENT FOR REQUIREMENTS AND DOCUMENT SUBMISSION INSTRUCTIONS. Offeror/Contractor NameContractorName: Federal Identification No.: Address: Solicitation/Contract NoContractNo.: City, State, Zip Code: M/WBE Goals: MBE % WBE % By submitting this form and the required information, the offeror/contractor certifies that every Good Faith Effort has been taken to promote M/WBE participation pursuant to the M/WBE requirements set forth under the contract.

OTHER CATEGORIES. DISABLED INDIVIDUAL any person who: - has a physical or mental impairment that substantially limits one or more major life activity(ies) - has a record of such an impairment; or - is regarded as having such an impairment. • VIETNAM ERA VETERAN a veteran who served at any time between and including January 1, 1963 and May 7, 1975. • GENDER Male (M) or Female (F) PROC-1 (revised 2/2012) REQUEST FOR WAIVER FORM INSTRUCTIONS: SEE PAGE 2 OF THIS ATTACHMENT FOR REQUIREMENTS AND DOCUMENT SUBMISSION INSTRUCTIONS. Offeror/Contractor Name: Federal Identification No.: Address: Solicitation/Contract NoContractNo.: City, State, Zip Code: M/WBE Goals: MBE % WBE % By submitting this form and the required information, the offeror/contractor certifies that every Good Faith Effort has been taken to promote M/WBE participation pursuant to the M/WBE requirements set forth under the contract.